45D1044964 CLIA NUMBER - MARKET STREET PHARMACY # 675

Laboratory Demographics

  • CLIA Code: 45D1044964
  • Facility Name: MARKET STREET PHARMACY # 675
  • Facility Address: 4950 E 42ND STREET
    ODESSA, TX
    ZIP 79762
  • Facility Phone: 432 367-4612
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HENRY PHE
  • NPI Number: 1922045368
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1044964
LAB Type Pharmacy
Facility Name MARKET STREET PHARMACY # 675
Street 4950 E 42ND STREET
City ODESSA
State TX
ZIP 79762
Phone 432 367-4612
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Pharmacy
Lab Director HENRY PHE

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This page was last updated on: 9/29/2025